Abstract
Elderly patients with head and neck cancer are increasing in Japan. Although the indications for chemotherapy are judged by doctors, it is a remarkably difficult decision to make. There are many problems, such as the pros and cons of classification of chronological age, geriatric syndrome, and specific physical features, and the decision is made based on age, performance status, experience and so on. Recently, some tools for pre-treatment evaluation for one of the criteria for selecting chemotherapy have been developed.
The value of chemotherapy has been proven through many clinical trials but its effect on the survival of elderly patients is not clear because these trials have had a low percentage of elderly patients or an upper limit on age. There are no data in sub-group analysis suggesting the effectiveness of chemotherapy for older patients. The purpose of therapy is not always prolonging survival: relief of symptoms and maintenance of QOL are just as important. If the objective is clear and whether a drug therapy is safe and effective can be determined, then the therapy may prove useful.
New clinical trials for elderly patients are ongoing, especially for major cancers such as lung cancer, colon cancer and breast cancer. However, there are still very few trials for head and neck cancer, which is a challenge that needs to be solved. We should pay attention to not only head and neck cancer trials, but also other cancers.
